Transnational online education in biochemistry during and after the COVID-19 pandemic in Binzhou Medical University: challenges, strategies and outcome.

BACKGROUND: Due to the global outbreak of the COVID-19 epidemic, schools were forced to shift teaching from face-face to online. During this period, a large number of studies on how to better carry out online teaching emerged. However, these studies were basically conducted with domestic students as teaching objects. The research on transnational online education conducted by overseas students is very limited. METHODS: We first conducted a questionnaire survey on the obstacles of transnational online learning of 64 international students from our school who were staying abroad at the beginning of the fall semester of 2020, analyzed the results using the two-tailed student's t-test and changed the teaching platform accordingly and compared the results of the biochemistry exams conducted for 2018 spring class with those of 2018 fall class and the 2019 fall class, so as to verify the superiority of the DingTalk as a transnational online education platform. RESULTS: The results showed that the main difficulties of overseas students in transnational online learning are poor network conditions and time difference. By using DingTalk as an online teaching platform, these difficulties were overcome. In the spring class of 2018, the results of online study students' biochemistry were significantly lower than those of students in face-face study (t-test, p = 0.01). However, after the switch to the DingTalk platform, online students' results in the 2018 fall class (t-test, p = 0.35) and the 2019 fall class (t-test, p = 0.7) were equivalent to the academic performance of face-face students. CONCLUSION: Our exploration and application of DingTalk software in transnational online education successfully solved the dilemma of overseas students' online learning, and provided a feasible method to guarantee the efficacy of online teaching.

Follicular Helper CD4+ T Cells, Follicular Regulatory CD4+ T Cells, and Inducible Costimulator and Their Roles in Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis.

Follicular helper CD4+ T (TFH) cells are a specialized subset of effector T cells that play a central role in orchestrating adaptive immunity. TFH cells mainly promote germinal center (GC) formation, provide help to B cells for immunoglobulin affinity maturation and class-switch recombination of B cells, and facilitate production of long-lived plasma cells and memory B cells. TFH cells express the nuclear transcriptional repressor B cell lymphoma 6 (Bcl-6), the chemokine (C-X-C motif) receptor 5 (CXCR5), the CD28 family members programmed cell death protein-1 (PD-1) and inducible costimulator (ICOS) and are also responsible for the secretion of interleukin-21 (IL-21) and IL-4. Follicular regulatory CD4+ T (TFR) cells, as a regulatory counterpart of TFH cells, participate in the regulation of GC reactions. TFR cells not only express markers of TFH cells but also express markers of regulatory T (Treg) cells containing FOXP3, glucocorticoid-induced tumor necrosis factor receptor (GITR), cytotoxic T lymphocyte antigen 4 (CTLA-4), and IL-10, hence owing to the dual characteristic of TFH cells and Treg cells. ICOS, expressed on activated CD4+ effector T cells, participates in T cell activation, differentiation, and effector process. The expression of ICOS is highest on TFH and TFR cells, indicating it as a key regulator of humoral immunity. Multiple sclerosis (MS) is a severe autoimmune disease that affects the central nervous system and results in disability, mediated by autoreactive T cells with evolving evidence of a remarkable contribution from humoral responses. This review summarizes recent advances regarding TFH cells, TFR cells, and ICOS, as well as their functional characteristics in relation to MS.